Atopic dermatitis linked to cardiovascular disease

3 minute read

Atherosclerosis and cardiomyopathy only scratch the surface of the full list of cardiovascular conditions associated with AD.

Eczema can have significant implications for heart health, new research has found. 

Atopic dermatitis causes stress, sleep disturbances, anxiety and depression, but has also been linked to increased bodyweight, smoking and alcohol consumption.  

While these factors are all known to increase the risk of cardiovascular disease, there have been conflicting reports whether atopic dermatitis is associated with an increased risk of cardiovascular disease. 

A recent study, published in Clinical and Experimental Dermatology, provides more conclusive evidence of an association, reporting patients with atopic dermatitis have an increased risk of over 50 different cardiovascular diseases

“Atopic dermatitis is a highly prevalent chronic inflammatory skin condition that affects millions worldwide. Identifying any associated increased risk of serious comorbidities like cardiovascular disease is important for optimal patient care and prevention efforts,” Professor Garry Jennings, the Heart Foundation’s chief medical officer, told Allergy & Respiratory Republic.  

As part of the propensity-matched retrospective study, researchers examined 20 years of medical records for more than two million patients (half of whom had atopic dermatitis) to analyse the association between atopic dermatitis and cardiovascular disease.  

After matching dermatitis patients and controls on important factors such as age, ethnicity, gender and other known cardiovascular risk factors (e.g., smoking, obesity and diabetes status), patients with atopic dermatitis were found to have a greater risk of developing any one of 53 different cardiovascular diseases. 

The largest increase in risk for atopic dermatitis patients compared to controls was for chronic peripheral venous insufficiency (63%), followed by atherosclerosis (53%) and congestive heart failure (43%). 

Increases in the risk of pulmonary hypertension (31%), atrial fibrillation (28%), cardiomyopathy (27%), venous thromboembolism (23%) and acute myocardial infarction (19%) were also observed.    

The researchers suggested the long-lasting systemic inflammation associated with atopic dermatitis led to an increased risk of cardiovascular disease. They also felt the increased risk “might be a consequence of oral corticosteroid treatment”.  

Professor Jennings agreed systemic inflammation could be a key factor linking the two conditions and felt “elucidating this connection could provide insights into shared disease mechanisms and potential therapeutic targets”. 

The study did not explore the association between disease severity and the risk of developing cardiovascular disease, which could potentially change the presence and strength of associations in different patients. 

“Thus, [the] presented results might even present with increased hazard ratios in patients with more severe atopic dermatitis, while patients with mild atopic dermatitis might not be at [an] increased risk for cardiovascular diseases,” the researchers wrote. 

Professor Jennings recommended clinicians apply increased vigilance regarding screening for cardiovascular risk factors in younger atopic dermatitis patients, especially those with severe disease. 

“A Heart Health Check is subsidised by Medicare for everyone aged 45-79 years and even younger for people with Diabetes or for First Nations people,” he told ARR.  

Clinical and Experimental Dermatology 2024, online 4 May 

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